Other than an A&E department or a GP surgery, where is one of the safest places in the UK to have a heart attack?
The unlikely answer is on a racecourse. 'At every race meeting you have two or three doctors, a nurse, there is a medical room where you can be taken that is equipped with a defib and there are a couple of ambulances on site,' explains former GP Dr Anna-Louise Mackinnon.
Consistency of care
Such robust medical arrangements mean that treatment complications are more likely after you are whisked away in an ambulance, she says. 'Sometimes you are dumped in A&E and if it is particularly busy things can go a bit pear-shaped.'
The issue of ensuring consistency in the treatment of injuries sustained on a racecourse is one of the reasons why the Professional Jockeys Association (PJA), the representative body for jockeys within British horseracing, appointed Dr Mackinnon as its first medical adviser in January 2009.
Dr Mackinnon was a GP principal in Thatcham, Berkshire, when the post was advertised. When she heard of it, she realised it was the perfect opportunity to marry her medical skills with one of her life's passions.
'What the PJA wanted was a GP with an interest in racing and a diploma in sports and exercise medicine and that is basically what I have,' she explains.
Profession meets passion
In addition to owning an eventing horse, which she rides in competitions, Dr Mackinnon regularly rides out for a top UK trainer and is married to Sandown Park racecourse's managing director.
She is also a part-time event doctor at British eventing competitions. This wealth of experience gives her an insight into the mindset of jockeys.
'I know what the jockeys are going through and some of the pressures they are under to earn a living. They are only paid when they ride so they have to be back on their horses as soon as possible after an injury.'
She adds that they will put on a brave face and cover up all sorts of injuries just to ride again.
Although very serious injuries are fairly rare, statistics show that jump jockeys have one fall every 10 rides on average, and that 17 per cent of those falls result in injuries. While flat jockeys fall less frequently, 40 per cent of falls result in an injury because they tend to ride faster.
These injuries range from fractured collarbones or shoulder ligament damage to fractured vertebrae or concussion.
'I can help them see the right consultants and review injuries if they're not recovering quickly enough. I will also make sure the communication is happening properly between the different interested parties. So much of medicine comes down to good communication.'
Dr Mackinnon's salary is in the region of a salaried GP's. Although contracted to work five days a week, it did not take her long to realise that she would not have a typical nine to five role.
'It's five days a week in the office but then on a Saturday I might go racing so I will pop into the weighing room, meet the physio and check if anyone wants to be seen.'
On call for injured jockeys
As well as meeting jockeys at the racecourse, the PJA's 400-plus members have her mobile phone number so that in an emergency they can contact her outside office hours.
If their condition is non-urgent then they can make an appointment to see Dr Mackinnon in Lambourn, Berkshire, where a new rehabilitation facility is being built for the Injured Jockeys Fund (IJF).
Part of her remit is to work closely with the IJF, which part-funded her post along with the online betting exchange Betfair.
Her new job meant relinquishing her GP partnership. But Dr Mackinnon plans to keep up-to-date with revalidation and appraisal by doing the occasional GP locum session. She is also working towards a diploma in occupational medicine.
The PJA's new medical adviser says she needs to spread the word to jockeys about the medical facilities already in place to help them get the best possible rehabilitation. Further down the line she hopes to launch a series of audits and research projects, with an emphasis on education.
'The British Racing School (the racing industry's training centre) gives jockeys a grounding in what they should and shouldn't be doing to look after themselves, but I have to keep that education going,' she says.
Dr Mackinnon also looks forward to getting back in the saddle at the trainer's stable as she has struggled to find time for this while juggling the responsibilities of her 'dream job'.
'This new role brings everything together that I am interested in and enjoy doing. Racing is a lifestyle choice and this role perfectly fits in with my life.'
- For more photos of Dr Mackinnon go to www.healthcarerepublic.com/galleries
PROFILE: Dr Anna-Louise Mackinnon
|Job title Medical adviser to the Professional Jockeys Association. |
Salary: On a par with salaried GP pay.
Family: Married with two children to David Mackinnon, managing director of Sandown Park racecourse.
Qualifications: MRCGP, diploma in sports and exercise medicine, working towards a diploma in occupational medicine.
Previously GP principal at Thatcham Medical Practice, Berkshire, for five years. Before that, she was on the GP vocational training scheme in Bath for three years.